1. Field of the Disclosure
This disclosure relates generally to methods and systems for filling medication containers and, in particular, to a method of determining an order of filling a multi-dose medicament container for a plurality of prescriptions, nutraceuticals, vitamins, over-the-counter medications, etc.
2. Background Description
Traditional methods of packaging, for example, prescription medicaments include dispensing an entire single prescription's worth of pills into a single medicament container affixed with a label displaying (among other data) patient identification, pill identification, dosage, and ingestion instructions. If a patient needs to take multiple medications, a single, filled medicament container is typically issued for each prescription. Furthermore, if a patient is required to take the multiple medications at different times of the day and/or night, the patient must have all of the single, filled medicament containers readily available, and the patient must remember when, which and how many pills he or she needs to take. Thus, traditional methods of packaging multiple prescription medicaments result in inconvenience to the patient as entire sets of single, filled medicament containers must be brought along. Other undesirable effects of traditional packaging methods include difficulty for the patient in remembering the time, the type, and the number of pills to take. These types of problems may lead to a patient failing to take a medicine at the appropriate time or taking too much medicine within a short period of time, which may cause adverse affects to the patient's health.
Recent advances in prescription packaging have attempted to mitigate these problems. For instance, a multi-dose blister pack may be used to fill a plurality of prescriptions for a patient. Examples of multi-dose blister packs may be found in U.S. Provisional Patent Application Ser. No. 60/947,169 entitled “Nested Multi-Dose Blister Pack,” the entire disclosure of which is incorporated by reference. A machine and process for filling multi-dose blister packs may be found in U.S. Provisional Patent Application Ser. No. 60/940,790 entitled “Multi-Dose Filling Machine and Process,” the entire disclosure of which is also incorporated by reference.
Multi-dose blister packs may contain a plurality of individual blister cells, each of which may hold one or more pills of different medications prescribed for a patient. One multi-dose blister pack, for instance, may include a label “morning,” so that each individual blister cell on the “morning” pack may contain the complete set of pills from a patient's multiple prescriptions that are to be ingested in the morning. Of course, the multi-dose blister pack may also include other labels related to information other than the dosage regime. The patient may also receive additional filled, multi-dose blister packs that have individual blister cells, some or each containing the correct multiple medications to be ingested at “noon” and “night.” Alternatively, blister packs may be filled to a different level of granularity. For example, a single multi-dose blister pack may have rows labeled “morning,” “noon,” and “night” and have columns labeled with the day of the week. So, on Tuesday night, the patient would ingest the correct set of pills from his or her multiple prescriptions by taking the pills from the individual blister cell located at the intersection of the “night” row and the “Tuesday” column. Other fill patterns of multi-blister packs are also possible.
Multi-dose blister packs may be perforated into individual, easily-portable blister cells. In some embodiments, the blister cells on a single multi-dose blister pack may be similarly sized. Alternatively, some of the blister cells on a certain blister pack may be sized differently to accommodate a different number or volume of pills, for example. Each blister cell may be labeled on the back with the different medications contained within the blister cell, and may also list patient information, time/day/date information for ingestion, and the like. A patient may separate out from the pack the specific blister cells that he or she will need during a specific time period, and thus does not need to carry multiple large single filled medicament containers for each of his/her multiple prescriptions. The patient is not required to sort out the dosages of multiple medications for a particular dosage regime. Additionally, the labeling on the blister packs may aid the patient in keeping track of whether medications have been taken.
Another example of an advance in prescription packaging is an individual medicament pouch or packet. Examples of individual medicament pouch/packets may be found in U.S. patent application Ser. No. 11/741,539 entitled “Serially Connected Packets with Grasping Portion” and in U.S. patent application Ser. No. 11/741,542 entitled “Serially Connected Packets with End Indicator.” The total combination of medications that are prescribed to be ingested at a same time may be filled into an individual medicament pouch or packet. A label may be affixed or printed directly onto the pouch that displays the time/day/date for ingestion, patient information, and medicaments contained inside the pouch. Thus, a patient need only port along the pouches that s/he will need during a specific time period. The patient need not determine what combination of pills needs to be taken at various times, as the individual filled pouches provide the groupings. The time/day/date label assists the patient in remembering whether or not the medicaments have been ingested or not.
Thus, a “multi-dose medicament container,” as used herein, is a receptacle that holds a set of medications, over-the-counter pills, vitamins, or nutraceuticals corresponding to multiple prescriptions or non-prescription dosages of a patient, usually (but not necessarily) on a per-ingestion time basis. A multi-dose medicament container may have a single receptacle, such as a traditional prescription container or a pouch. A multi-dose medicament container may have multiple receptacles, such as a blister pack. Other types of multi-dose medicament containers may be possible. A “dosage regime,” as used herein, may refer to time of ingestion for example and is a general time reference for ingestion of the medication rather than an exact time on a clock. For instance, a dosage regime may be with an evening meal, before or after a meal, every other day, and the like. Further, the dosage regime may specify or restrict ingestion according to prescription directions or medication directions (e.g., for nutraceuticals and OTCs).
Filling the multi-dose blister packs, pouches, and other multi-dose medicament container configurations may be done manually or automatically. A “fill pattern,” as used herein, is defined as a mapping of pills from one or more prescriptions of a patient into one or more receptacles of one or more multi-dose medicament containers. Fill patterns may be complex. For example, in the case of a blister pack, if Prescription A is required to be ingested once a day, and Prescription B is required to be ingested twice a day, the fill pattern may perform the appropriate mapping so that each labeled blister cell of the blister pack contains the appropriate combination of pills. A “morning” blister cell may be mapped to contain two pills, one of Prescription A and one of Prescription B. An “evening” blister cell may be mapped to contain only one of Prescription B's pills.
A pattern of filling a multi-dose container for one or more medications may be determined in view of such factors as the cubic volume of an individual pill, the prescribed or suggested dosage regime of each medication, the number of times a particular medication is to be ingested, etc. However, filling a multi-dose container such as a blister pack according to a determined pattern may not always produce the desired result due to the differences in volume, shape, and weight of the medication pills. For example, depositing a relatively small pill into a blister cell prior to depositing a relatively large pill into the same cell may result in an inefficient configuration of the pills in the cell. In particular, the larger pill may not fit into the cell, or may prevent another pill from fitting into the cell.
Moreover, filling a multi-dose blister pack may require complex manipulations of single-medication blisters or other sources. For example, a patient may be prescribed five types of medication to be ingested over the course of one or more weeks. The five types of medication may be available as pills in the form of capsules, tablets, etc., and may be packaged in single-medication blister cells or other types of containers. Preferably, a single weekly multi-dose blister pack can include all five prescribed medications which may be distributed among the cells of the blister pack according to a particular fill pattern. However, a single blister pack may not always accommodate all prescribed pills. The fill pattern may accordingly require multiple multi-dose blister packs. For example, a patient may have multiple “morning” blister packs and may need to open multiple individual blisters, one in each blister pack, at a particular time of day to retrieve all of the required medication, or may require an additional weekly card. Moreover, some of the pills of the same type may need to be distributed into multiple blisters. For example, the patient may be prescribed two dosages of a certain medication four times a day, and the medication may be available as a large pill. A system for determining a fill pattern (or a pharmacist) may determine that only one of the two pills can fit into an individual blister cell and, as a result, decide to place each of the two pills into separate blister packs. Thus, a filling unit or a pharmacist may retrieve medication from multiple sources at different stages of filling one or multi-blister packs. Depending on the order in which the system or pharmacist retrieves medication, each of the source containers may be accessed once or multiple times. In other words, the order of fill will frequently have direct impact on a number of operations performed while filling a prescription and, therefore, on the overall efficiency of prescription filling.